Outcome from integrated pain management treatment for recovering substance abusers

J Pain. 2003 Mar;4(2):91-100. doi: 10.1054/jpai.2003.17.


There is little information on the efficacy of pain management for substance abusers with noncancerous chronic pain conditions. The present study describes an outcome evaluation of a pain management group adapted to the needs of patients diagnosed with concurrent chronic pain and substance abuse disorders. A heterogeneous group of 44 patients (66% opioid dependent; 61% musculoskeletal pain) attended a 10-week outpatient group based within a multidisciplinary substance abuse treatment program. Measures of addiction severity, pain, use of self-management techniques, emotional distress, medication use, and functional status were obtained at pretreatment, post-treatment, 3-month, and 12-month follow-ups. Outcome data were analyzed on the group and individual level, the latter using the reliable change index. Intention-to-treat analyses showed significant improvements in pain, emotional distress, medication reduction, and coping style. Half of the patients showed a statistically reliable improvement on at least 1 outcome measure, and half were opioid free at the 12-month follow-up assessment. These results suggest that persons with concurrent chronic pain and substance use disorders are responsive to an integrated treatment model of pain management and relapse prevention.

MeSH terms

  • Adult
  • Affective Symptoms / therapy
  • Analgesics, Opioid / therapeutic use*
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pain / complications
  • Pain / drug therapy*
  • Pain / psychology
  • Pain Clinics*
  • Pain Measurement
  • Patient Participation
  • Secondary Prevention
  • Severity of Illness Index
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / therapy*
  • Treatment Outcome


  • Analgesics, Opioid